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Application Form - A-level center (15-18 years old)

(As per Their Passport 以护照为准)

Please put NA if not applicable.

Subject to age restrictions, the relevant department will contact you for supporting Scholarship documents. 根据年龄的限制,本校相关部门会就奖学金事宜与您联络。

Language | 语言信息

Other Languages Spoken | 其他语言

Activities and Interests | 活动和兴趣

Parents information from both sides are highly suggested.

Parent Information

Other Languages Spoken | 其他语言

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If you are unsure about creating a personal account but would like more information about Wellington College International Tianjin, please contact our admissions team on + 86 022 – 87587199, or email to

Work Address | 工作所在地地址

China Address | 中国现居住地地址

Home Country Address | 本国家庭住址

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Siblings Information

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Additional Information
Academic History | 就学经历

(Most Recent First 从最近求学的学校开始)

Previous Schools

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Asperger’s Syndrome | 阿斯伯格综合征
Attention Deficit Hyperactivity Disorder | 注意力不足过动症
Autism | 孤独症
Dyslexia | 阅读障碍症
Dyspraxia | 运用障碍
Depression | 抑郁症
Eating Disorder | 厌食症
Emotional/Behavioural Delay/Disorders | 情绪/行为发育迟缓症
Language and Speech Delay/Disorders | 语言发育迟缓症
Learning Disabilities | 学习障碍
Any other condition which we should be aware of | 其他您认为校方应该了解的孩子情况

Medical Information | 医疗信息

Please select Yes if your child has (or has had in the past) any of the following conditions and provide additional information on such condition (or any other condition if not listed).
如果您的孩子具有(或者曾经有)下述状况,请在表格内标示 “Yes”,并向校方提供孩子的详细情况说明 (如您的孩子的情况并未出现在下列表格中,请务必向学校说明。)

Health Information
Immunization Record

Has your child received the following vaccinations? 您的孩子是否曾接种过下列疫苗?

Measles Mumps Rubella (MMR) | 麻疹腮腺炎风疹

Date of Vaccination | 接种疫苗日期

Diphtheria Pertussis Tetanus (DPT) | 百日咳白喉破伤风

Date of Vaccination | 接种疫苗日期

Hepatitis B (HepB) | B型肝炎

Date of Vaccination | 接种疫苗日期

Hepatitis A (HepA) | A型肝炎

Date of Vaccination | 接种疫苗日期

Tuberculosis (B.C.G.) | 肺结核

Date of Vaccination | 接种疫苗日期

Haemophilus Influenzae Type B (Hib) | B型流感嗜血杆菌

Date of Vaccination | 接种疫苗日期

Chicken Pox | 水痘

Date of Vaccination | 接种疫苗日期

Rabies | 狂犬病

Date of Vaccination | 接种疫苗日期

Annual Flu Vaccine | 年度流感疫苗

Date of Vaccination | 接种疫苗日期

If your child has medical insurance, please provide details. 如果您的孩子已经办理了医疗保险,请提供相关信息。

Note: Medical and Liability: The Parents are responsible for the medical insurance/insurance of Pupils while attending the College and must make provision before attending the College. Unless negligent or guilty of some wrongdoing causing injury, loss or damage, the College does not accept responsibility for accidental injury or other loss caused to the Pupil or the Parents/Guardian or for the loss or damage to property.


Person(s) to Notify in an Emergency

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Emergency Medical Treatment: It is the Parents/Guardians responsibility to make adequate provision for medical insurance during the pupil’s enrolment at the College.